Domestic Violence Project

Thomas Jefferson University Hospital (TJUH) is the proud and grateful recipient of a grant from the Verizon Foundation, funded with the purpose of enhancing the emergency department’s capacity to screen for domestic violence and to introduce appropriate interventions.

Domestic Violence is a pressing public health problem that takes many forms. From its physical and sexual, to emotional, psychological and financial manifestations, abuse is both vast and far-reaching. Domestic Violence is additionally a widespread crisis affecting individuals of all cultures, religions, ages, sexual orientations, and income levels. This public health concern is one in desperate need of attention, and the statistics are staggering. In the city of Philadelphia alone, the Police Department responded to some 71,350 domestic abuse incidents in 2006 (WWA).

There is an expectation bestowed upon the health care providers at Jefferson. They strive to be actively involved in the continuing health and well-being of their patients. An educated and informed response to cases of Domestic Violence is a pivotal step in insuring the safety of a patient and preventing imminent violence. We recognize that healthcare providers are at the front lines in the effort to combat this social ill and to assist victims to break free from the cycle of violence. This grant, coupled with the Center for Disease Control and Prevention’s (CDC) RADAR system, has allowed Thomas Jefferson to strengthen its comprehensive training program, enabling the entire emergency staff to better identify abuse and provide treatment for those in need.

The Emergency Department at Jefferson has recognized the severity of Domestic Violence in Philadelphia. This recent partnership with Verizon will allow healthcare providers to identify problems and provide compassionate care to all those victims suffering from this growing health concern.

Types of Abuse:

It is important to understand that Domestic Violence is not limited to physical violence; it is instead defined more broadly as a chronic abuse of power. This abuse can therefore manifest physically, psychologically, emotionally, sexually, or financially.

• Physical: Physical Abuse generally stems from minor contact that escalates over time into more aggressive behavior and physical attacks causing injury, bruising, broken bones, internal bleeding, and even death.
• Psychological/Emotional: Mental and Emotional Abuse is often perpetrated through name-calling, threats, harassment, and constant criticism. This abuse, however, is described more broadly as anything that would affect the mental health of the abused.
• Sexual: Sexual Abuse often accompanies or follows physical abuse. In such cases, the victim is forced unwillingly to have sexual intercourse or engage in unwanted sexual activities.
• Financial/Economic: Financial and Economic Abusers generally maintain complete control over all of the victim’s resources, including financial funds. This can include transportation, food, shelter, clothing, and money. The abuser often uses this control as a way to prevent the victim from attempting to leave.

What is TJUH’s plan?

While the current Domestic Violence statistics are staggering, the number of cases that go unreported and the number of victims who go unaided is equally if not more disturbing. Many factors- including shame, feelings of hopelessness, and a lack of a safe refuge, too often discourage and prevent victims from reporting their abuse to the authorities. The National Violence Against Women found that approximately 1/5 of rapes, and ¼ of all physical assaults are not reported to the authorities every year. Therefore, for many victims, the ED is the first stop on their road to recovery. Victims who arrive with serious life threatening injuries deserve immediate care for their current maladies as well as follow up by the ED staff as to the nature and origins of their injuries. With the CDC’s RADAR system and the Verizon Foundation’s generous contribution, the entire ED staff can more effectively identify abuse, provide treatment, and refer abuse victims to receive help.

R- Routinely Screen Patients
A- Ask Direct Questions
D- Document Your Findings
A- Assess Patient Safety
R- Review Options and Referrals

The new program at TJUH is mandating that all emergency staff be educated and provided with appropriate training to implement RADAR in the ED. We know that in many cases, for various reasons, victims are reluctant to go to the authorities. However, often their injuries are extreme enough to warrant emergency medical care. Therefore, it falls on the health care providers to help guide victims out of these abusive situations. It is Jefferson’s ultimate goal to provide their ED staff with the tools and knowledge to identify victims and help them break free from a vicious cycle of violence and abuse.